上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2017, Vol. 37 ›› Issue (12): 1678-.doi: 10.3969/j.issn.1674-8115.2017.12.018

• 论著（临床研究） • 上一篇    下一篇

急性脑梗死患者血清陷窝蛋白1水平与早期神经功能恶化的关系

钟义良，张融融，黄思源，秦新月   

  1. 重庆医科大学附属第一医院神经内科，重庆  400016
  • 出版日期:2017-12-28 发布日期:2018-01-10
  • 通讯作者: ?秦新月，电子信箱：qinxy20017@sina.com
  • 作者简介:钟义良 (1989—)，男，硕士生；电子信箱：onionzyl@163.com

Relationship between serum level of caveolin-1 and early neurological deterioration in patients with acute cerebral infarction#br#

ZHONG Yi-liang, ZHANG Rong-rong, HUANG Si-yuan, QIN Xin-yue   

  1. Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
  • Online:2017-12-28 Published:2018-01-10

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摘要： 目的 · 研究急性脑梗死患者血清陷窝蛋白 1(Cav-1) 水平与早期神经功能恶化 (END) 的关系。方法 · 选取 2016 年 7 月—2017 年 1 月重庆医科大学附属第一医院神经内科收治的急性脑梗死患者126 例，ELISA 法检测血清Cav-1 水平，同时采用美国国立卫 生研究院脑卒中量表（NIHSS）、格拉斯哥昏迷量表（GCS）评估患者神经功能缺损程度。与入院NIHSS 基线评分比较，若患者入 院 3 d 内第2 次 NIHSS 运动评分项增加≥1 分或总分增加≥2 分，则归入END 组，否则归入非END 组。多因素Logistic 回归分 析患者发生END 的独立预测因子，ROC 曲线分析Cav-1 预测END 的准确性。结果 · END 组血清Cav-1 水平较非END 组显著升 高 [(29.88±19.57) ng/mL vs (16.08±13.37) ng/mL，P=0.000]。ROC 曲线分析血清Cav-1 预测END 的最佳切点为16.55 ng/mL，灵 敏度和特异度分别为73.33% 和 74.07%。Logistic 分析显示，Cav-1 ≥ 16.55 ng/mL 是急性脑梗死患者发生END 的独立预测因子 （OR=4.936，95% CI 为 1.608 ～ 15.155，P=0.005）。 结论 · 血清 Cav-1 水平是急性脑梗死发生 END 的独立预测因子。

关键词: 急性脑梗死, 陷窝蛋白 1, 预测因子, 早期神经功能恶化

Abstract:

Objective · To investigate the relationship between serum level of caveolin-1 (Cav-1) and early neurological deterioration (END) in patients with acute cerebral infarction.  Methods · A total of 126 consecutive patients with acute cerebral infarction were recruited from July 2016 to January 2017 in Department of Neurology, the First Affiliated Hospital of Chongqing Medical University. The serum Cav-1 levels of all patients were detected by enzyme-linked immunosorbent assay (ELISA) test. The neurological deficits were assessed by the National Institutes of Health Stroke Scale (NIHSS) and the Glasgow Coma Scale (GCS) at the same time. Compared with the admission baseline NIHSS score, if second motor NIHSS score increased ≥ 1 point or the total NIHSS score increased ≥ 2 points within 3 days after hospitalization, they were classified as END group, otherwise they were classified as non-END group. Multivariable Logistic regression analysis was used to examine the independent predictors of END in the patients. Receiver operating characteristic (ROC) curves were obtained to explore Cav-1 levels in predicting END.  Results · Serum Cav-1 levels in END group were significantly higher than those in non-END group [(29.88±19.57) ng/mL vs (16.08±13.37) ng/mL, P=0.000]. Based on the ROC curves, the best cut-off point of serum Cav-1 for predicting END was 16.55 ng/mL. The sensitivity and specificity were 73.33% and 74.07%, respectively. Multivariable Logistic regression analysis showed that Cav-1 ≥ 16.55 ng/mL remained an independent predictor of END (OR=4.936, 95%CI 1.608-15.155, P=0.005).  Conclusion · Serum Cav-1 is an independent predictor of END in patients with acute cerebral infarction.

Key words: acute cerebral infarction, caveolin-1, predictor, early neurological deterioration